The GI Surgeon and Gastroparesis

54 OVERVIEWS OF GASTROPARESIS Gastroparesis is characterized by delayed or impaired passage of gastric contents in the absence of mechanical obstruction. Symptoms vary and include nausea, vomiting, bloating, and abdominal pain. The symptoms and clinical presentation of gastroparesis is reflective of its pathogenesis, severity, and association with predisposing or associated conditions. Gastroparesis is related to a variety of underlying disorders. The most common causes of gastroparesis are diabetic, postsurgical and idiopathic (1). The true prevalence of gastroparesis is unknown. It is thought to occur in 20%–40% of patients with Type I diabetes mellitus and about 20% of patients with type II diabetes. Delayed gastric emptying occurs in about 25% of patients with functional dyspepsia, a disorder which includes a constellation of abdominal complaints that affects up to 20% of the U.S. population (2). Patients may develop gastroparesis after undergoing foregut surgery with or without vagotomy. One study noted that up to 8% of patients with postsurgical gastroparesis had developed symptoms after cholecystectomy (3). An increasing awareness is being paid to post-Nissen gastroparesis. Finally, the third most common The GI Surgeon and Gastroparesis GI MOTILITY, A SERIES FROM THE AMS, SERIES #9